Department of Internal Medicine, University of Toronto, Toronto, ON.
Curr Oncol. 2013 Apr;20(2):e161-4. doi: 10.3747/co.20.1200.
Very late recurrence of gastric cancer is rare. Here, we report a dramatic recurrence of gastric cancer, with isolated skeletal metastasis and bone marrow carcinomatosis, 22 years after the patient's initial presentation. Gastric cancer recurrence involving bone or bone marrow is also uncommon and associated with poor prognosis. Pathology from a bone marrow biopsy showed signet ring cell morphology. The patient in this case demonstrated a surprising response-lasting 11 months-to palliative chemotherapy with cisplatin and capecitabine. This case report and literature review describes the characteristics of late gastric cancer recurrence and an approach to the diagnosis and management of patients with bone metastasis or bone marrow carcinomatosis.
胃癌的非常晚期复发非常罕见。在这里,我们报告了一例患者在初次就诊 22 年后,出现孤立性骨骼转移和骨髓转移的显著胃癌复发。胃癌累及骨骼或骨髓的复发也不常见,且预后不良。骨髓活检的病理显示出印戒细胞形态。本例患者对顺铂和卡培他滨姑息化疗表现出惊人的反应,持续了 11 个月。本病例报告和文献复习描述了晚期胃癌复发的特征,以及诊断和治疗骨骼转移或骨髓转移患者的方法。